Evaluation of Demyelination Procesactivity in Patients with Multiple Sclerosis by Magnetization Transfer

Purpose: to study the activity of demyelination process in patients with multiple sclerosis using magnetization transfer effect.

Materials and methods. Рatients group of 10 people aged from 19 to 48 years old with a confirmed diagnosis of multiple sclerosis was formed for clinical testing. Contrastcontaining and fat-containing substances scanned with offset frequency used as the material for the phantom studies. MRI investigation was performed on high field magnetic resonance tomograph with 1.5 Tesla magnetic field. To obtain T1-weighted images in the phantom experiment the Spin-Echo pulse sequence with parameters: TR = 650 ms, TE = 20 ms, FOV = 14 cm, MX = 96 × 256, STh = 4.7 mm with the imposition of a single pulse of magnetization transfer (MTS = 1) was used. Magnetization transfer ratio (MTR) was used to quantify the magnetization transfer effect. The Spin-Echo pulse sequence with the following parameters: TR = 621 ms, TE = 17 ms, FOV = 23.4 cm, MX = 208 × 320, STh = 5.0 mm was used in the clinical trial.After the administration of contrast medium the same pulse sequence with applying magnetization transfer pulse (MTC = 1) was used. Contrast ratio was calculated for evaluating the contrasting effect.

Results. The greatest MTR value was obtained when the phantom study with a combination of frequency offset (Δf) and flip angle (FA(MT)): Δf = −210 Hz and FA(MT) = 600° respectively. Clinical approbation of this combination showed a statistically significant increase in contrast ratio (p < 0.05) between the demyelination foci and white brain matter in comparison with the sequence without magnetization transfer effect. In addition significant differences in MTR coefficients revealed between the intact white matter and demyelination foci (p < 0.05). The sensitivity of T1-weighted sequence with the magnetization transfer effect in identification of active foci of demyelination was significantly higher (p < 0.001) than that sensitivity of T1-weighted sequences without the magnetization transfer effect.

Conclusion. The improved visualization of active foci of demyelination in patients with multiple sclerosis using a sequence with magnetization transfer effect with the following parameters: Δf = −210 Hz, FA(MT) = 600° due to the high values of contrast ratio compared with T1-Spin-Echo (p < 0.05) was shown and significant reduction in MTR coefficient in demyelination foci (p < 0.05).

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